ISA*00*          *00*          *ZZ*000000005D  *ZZ*OO000011111    *180710*2143*^*00501*000001770*1*P*:~
GS*HC*000000005D*OO000011111*20180710*214339*1770*X*005010X222A1~
ST*837*000000001*005010X222A1~
BHT*0019*00*1*20180710*214339*RP~
NM1*41*2*ABCDEF*****46*123456789~
PER*IC*ABCDEF CUSTOMER SOLUTIONS*TE*9999999999~
NM1*40*2*ABCHYI OL POI*****46*YTHF281123456~
HL*1**20*1~
PRV*BI*PXC*1223G0001X~
NM1*85*2*YYYY HEALTHCARE ABC*****XX*1222222220~
N3*123 ADDRESS1~
N4*FAKE CITY*NY*908021112~
REF*EI*123456789~
PER*IC*YYYY HEALTHCARE ABC*TE*1222222221~
NM1*87*2~
N3*123 ADDRESS2~
N4*FAKE CITY*NY*908021112~
HL*2*1*22*0~
SBR*P*18*ABCDE01234******CI~
NM1*IL*1*ABCDEFGH*IJKLMNOP*B***MI*111111100~
N3*123 ADDRESS3~
N4*FAKE CITY*CA*908021112~
DMG*D8*19650101*M~
NM1*PR*2*ABCHYI OL POI*****PI*ABCMMPIO~
CLM*ABC11111*1800***22:B:1*Y*A*Y*Y~
DTP*454*D8*20180123~
DTP*304*D8*20180123~
REF*EA*6123456749~
REF*D9*012345678901234~
NTE*ADD*1513 TO 1641~
HI*ABK:G5621~
NM1*DN*1*ABCD*STUVW****XX*1234567890~
NM1*82*1*TUVWX*MNOPQR****XX*1234567891~
PRV*PE*PXC*367500000X~
NM1*77*2*ABCDEFG HIJKLMN HOSP*****XX*1122334460~
N3*123 ADDRESS4~
N4*FAKE CITY*CA*908021114~
LX*1~
SV1*HC:01710:QZ::::64718*1800*MJ*88***1~
DTP*472*RD8*20180123-20180123~
REF*6R*09876543210~
NTE*ADD*START 1254 STOP 1461~
HL*3**20*1~
PRV*BI*PXC*1223G0001X~
NM1*85*2*ABCDE EFGHIJ GROUP PC*****XX*1222222223~
N3*123 ADDRESS5~
N4*FAKE CITY*CA*908021115~
REF*EI*543211234~
PER*IC*ABCDE EFGHIJ GROUP PC*TE*1222222221~
NM1*87*2~
N3*123 ADDRESS6~
N4*FAKE CITY*CA*908021116~
HL*4*3*22*0~
SBR*P*18*EM00123******MC~
NM1*IL*1*ABCDEFGH*IJKLMNOP*B***MI*11111117~
N3*123 ADDRESS7~
N4*FAKE CITY*CA*908021117~
DMG*D8*19760101*F~
REF*SY*125478963~
NM1*PR*2*ABCHYI OL POI*****PI*ABCMMPIO~
CLM*ABC111112*984***22:B:1*Y*A*Y*Y~
DTP*454*D8*20180713~
DTP*304*D8*20180713~
REF*EA*1254789634~
REF*D9*012345678901231~
HI*ABK:K219~
NM1*DN*1*ABCDEFG*OPQRST*A***XX*1122334460~
NM1*82*1*STUVW*KLMNOP*H***XX*1122334461~
PRV*PE*PXC*207L00000X~
NM1*77*2*ABCDEFG HIJKLMN HOSP*****XX*1122334450~
N3*123 ADDRESS8~
N4*FAKE CITY*CA*908021118~
LX*1~
SV1*HC:00731:AA:P3:::43235*984*MJ*24***1~
DTP*472*RD8*20180713-20180713~
REF*6R*1235478963~
NTE*ADD*START 0822 STOP 0846~
HL*5**20*1~
PRV*BI*PXC*1223G0001X~
NM1*85*2*ABCDE EFGHIJ GROUP PC*****XX*1477527786~
N3*123 ADDRESS9~
N4*FAKE CITY*CA*908021119~
REF*EI*931013923~
PER*IC*ABCDE EFGHIJ GROUP PC*TE*1222222221~
NM1*87*2~
N3*123 ADDRESS10~
N4*FAKE CITY*CA*908021111~
HL*6*5*22*0~
SBR*P*18*EM00003******MC~
NM1*IL*1*ABCDEFGH*IJKLMNOP*B***MI*111111111~
N3*123 ADDRESS11~
N4*FAKE CITY*CA*908021111~
DMG*D8*20180409*M~
NM1*PR*2*ABCHYI OL POI*****PI*YTHF281123456~
CLM*ABC111113*1353***22:B:1*Y*A*Y*Y~
DTP*454*D8*20180713~
DTP*304*D8*20180713~
REF*EA*963852741~
REF*D9*548721986532651~
HI*ABK:K4090~
NM1*DN*1*ABCDEFGH*OPQRSTU*A***XX*1122334456~
NM1*82*1*STUVWX*KLMNOPQ*H***XX*1122334457~
PRV*PE*PXC*207L00000X~
NM1*77*2*ABCDEFG HIJKLMN HOSP*****XX*1122334458~
N3*123 ADDRESS12~
N4*FAKE CITY*CA*908021112~
LX*1~
SV1*HC:00840:AA::::49320*1353*MJ*62***1~
DTP*472*RD8*20180713-20180713~
REF*6R*2154879865~
NTE*ADD*START 0726 STOP 0828~
HL*7*5*22*0~
SBR*P*18*EM00003******MC~
NM1*IL*1*ABCDEFGH*IJKLMNOP*B***MI*111111112~
N3*123 ADDRESS13~
N4*FAKE CITY*CA*908021113~
DMG*D8*20180504*F~
NM1*PR*2*ABCHYI OL POI*****PI*YTHF281123456~
CLM*ABC111114*1968***22:B:1*Y*A*Y*Y~
DTP*454*D8*20180713~
DTP*304*D8*20180713~
REF*EA*123456789~
REF*D9*215487986532544~
HI*ABK:Q423*ABF:G8918~
NM1*DN*1*ABCDEFGHI*OPQRSTUV*A***XX*1122334455~
NM1*82*1*STUVWXY*KLMNOPQR*H***XX*1122334456~
PRV*PE*PXC*207L00000X~
NM1*77*2*ABCDEFG HIJKLMN HOSP*****XX*1122334457~
N3*123 ADDRESS15~
N4*FAKE CITY*CA*908021115~
LX*1~
SV1*HC:00902:AA::::46705*1230*MJ*65***1~
DTP*472*RD8*20180713-20180713~
REF*6R*2156325632~
NTE*ADD*START 5248 STOP 1010~
LX*2~
SV1*HC:62322:59*738*UN*1***2~
DTP*472*RD8*20180713-20180713~
REF*6R*2541254125~
SE*138*000000001~
GE*1*1770~
IEA*1*000001770~
